Staff Retention in a Time of Never-Ending National Shortages
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In 2021, Carle Heart and Vascular Institute (HVI) Procedure Center was faced with a difficult staffing challenge, much like other facilities throughout the United States. Four service lines encompass the HVI: prep and recovery, interventional radiology (IR), cardiac cath lab (CL), and electrophysiology (EP). HVI is staffed by registered nurses, radiologic technologists, and healthcare technicians. We ended 2021 with 15 staff members leaving for various reasons: other job opportunities, career advancement (nurse practitioner [NP]/advanced practice provider [APP]), relocation, etc. Our annual voluntary staff turnover rate in 2021 was 20.37%, compared to only 4.81% in 2020.
To address the severe staffing shortage within our department, a team of HVI leaders, performance improvement champions, and other stakeholders helped design and implement recruitment and retention strategies to help meet the needs of our current staff. The overarching focus of these initiatives was to help staff achieve a positive work-life balance, therefore leading to meaningful retention and recruitment of staff that share our HVI culture.
One of the implemented high-level initiatives included RN and RT(R) After Hours On-Call (AHOC) positions for IR and CL both on weekdays and weekends. The AHOC program created exempt positions that are accountable for covering on-call cases at night and on weekends. This role assumes the on-call burden in exchange for a set wage. This initiative alone has significantly improved staff satisfaction and reduced the overall amount of call burden for all staff during a 6-week schedule. This position has also given flexibility for better work-life balance to staff who filled these roles in the form of alternative child care options and reducing feelings of burnout. Our pilot program involved one IR RN who started this role in late April 2021. This program expanded to two CL RNs for a weekday and weekend option in May 2022 and August 2022, respectively. Since then, we added one IR RT(R) weekday option, one IR RN weekend option, and one CL RT(R) weekday option. Success with this program is demonstrated in the reduction of on-call shifts and total hours worked on-call. From March 14th-April 24th, 2021, we saw one IR RN on-call for 13 primary and secondary shifts in a 6-week schedule reduced to only 6 secondary on-call shifts from January 15-February 25, 2023. During those same time periods, we saw the IR nursing staff working a total of 172.25 on-call hours, reduced to just 15.5 on-call hours worked. Additionally, we created job-sharing opportunities for employees in the ED, CVICU, and HVI that have allowed talented staff members to split their time between multiple departments in order to help reduce burnout and fatigue, as well as to allow opportunities for professional growth.
In order to boost employee recognition, we added a no on-call requirement for employees with greater than 25 years of service in October 2022, initiated an Employee of the Month Program in May 2022, and created “Lunch with Leaders” in November 2022 to connect with staff during their birthday month. We designed a “Rookie of the Year” award as a way for peers to nominate any employee with 18 months or less in HVI for exemplary behaviors and enhanced our Mentor Program to promote inclusivity and team bonding throughout all 4 service lines. The HVI Leadership team has also supported staff recognition through events such as “Pie Day”, themed Nurses, Radiologic Technologists, and Heath Care Technicians Weeks, milestone celebrations for employees with greater than 20 years of service, and an Employee Spotlight to highlight individuals in the department. In an effort to help staff realize the gifts they share each day, leaders spurred the creation of “Joy Books” which include positive comments from peer to peer.
As for recruitment strategies, we selected staff with meaningful connections to HVI to share their testimonials and passion for our work via social media platforms. Working with our Human Resources business partners, we have facilitated connections with local colleges, high schools, and healthcare programs to engage with students entering the workforce in hopes of sparking interest in a career within our organization. Community outreach is also an important part of HVI staff focus and we promote our teams by supporting their volunteering efforts with organizations like the American Heart Association and the Christie Clinic Illinois Marathon.
As of June 2023, HVI has 4 open full-time RN and 5 RT(R) positions, and we have hired 15 RNs and 5 RT(R)s full-time from January 2022-June 2023. In that same time, we have welcomed back 1 staff member who previously left for a job at another facility and have 2 staff members that returned to HVI full-time after traveling for over 1 year. Our annual voluntary turnover rate was reduced by 8%, from 20.37% in 2021 to 12.15% in 2022, with the implementation of the aforementioned initiatives (Additional data as of September 2023 are shown in the Table). We share these ideas for recruitment and recognition to help other facilities that may be struggling to find solutions to staffing and retention.
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